METHOD FOR DIFFERENTIATED ASSESSMENT OF DEGREE OF PATHOLOGICAL PROCESS PREVALENCE IN CHILDREN WITH PRIMARY FORMS OF TUBERCULOSIS Russian patent published in 2019 - IPC A61B6/03 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to phthisiopulmonology, paediatrics and radiation diagnostics, and can be used for differentiated assessment of degree of pathological process prevalence in children with primary forms of tuberculosis. An X-ray computed tomography of the thoracic organs is performed. A leading X-ray syndrome and degree of prevalence of pathological changes on the side of intramammary lymph nodes and/or lungs are determined. Processes with low, moderate and significant degrees of prevalence in children with primary forms of tuberculosis are detected. At presence of hyperplasia of intramammary lymph nodes irrespective of presence or absence of structural changes in them to low extent prevalence one-sided processes with defeat of 1-2 groups of intramammary lymphatic nodes in sizes from 10 mm up to 15 mm, to a moderate degree of prevalence, unilateral involvement of more than two groups of intramammary lymph nodes of 15 to 25 mm, to considerable degree of prevalence both one-sided, and two-sided damage of any number of groups of intramammary lymph nodes with size more than 25 mm is attributed. In the presence of calcints in the intramammary lymph nodes without their hyperplasia, a low degree of prevalence is attributed to either one-sided or bilateral involvement of the above and/or two groups with calcification size of up to 6 mm, to a moderate degree of prevalence, one-sided processes involving lesions of three or more groups with size of 7–10 mm or size of 10–15 mm, regardless of the number of groups, to a considerable degree of prevalence, two-way involvement of three and more groups with size of 7–10 mm or two and more groups with dimensions of 10–15 mm, as well as one-sided and two-sided damage with size of more than 15 mm, regardless of the number of groups. In the presence of small foci in lungs with size of 2 mm to a low degree of prevalence are one-sided processes with single foci, to a moderate degree of prevalence is the presence of multiple foci within one-two lobes in a single-sided process, presence of multiple centers within 2 and more lobes, both with one-sided and two-sided localization, is related to considerable prevalence. In presence of 3–5 mm-medium centers in the lungs to a low degree of prevalence, unilateral processes are considered to have single, not more than 6, nidi located within 2–3 segments; to moderate degree of prevalence are one-sided processes with single foci, no more than 6, within one-two lobes; to considerable degree of prevalence are both unilateral and bilateral processes with multiple centers within two and more parts. In the presence of large foci in lungs with size of 6–10 mm to a low degree of prevalence, single-sided single focus within one segment is attributed, to moderate degree of prevalence single, not more than 6, one-sided foci within one lobe; to considerable degree of prevalence are both unilateral and bilateral processes with multiple centers within two and more parts. In the presence of a lobular or subsegmental infiltrate in the lungs to a low degree of prevalence, the presence of a single-sided single infiltrate with size of 10–15 mm, to a moderate degree of prevalence, not more than two infiltrates with size of 15–25 mm, as in unilateral, and in bilateral processes; one-sided and two-sided infiltrates more than 25 mm, irrespective of their number, are referred to a considerable degree of prevalence. In the presence of segmental or partial infiltrates to a moderate degree of prevalence are the processes with lesions of not more than three segments of the lungs in both, and both lungs; one-sided or two-sided processes with lesion of more than three segments are referred to a considerable degree of prevalence. In the presence of additional X-ray changes in the form of dissemination centers, destructive changes in pulmonary tissue, changes on the side of pleural covers, including free effusion, irrespective of the leading X-ray syndrome, processes are attributed to a considerable degree of prevalence. If pathological changes in the lungs and intramammary lymph nodes are combined, the prevalence of the process is determined by the maximum degree of involvement.

EFFECT: method provides wider range of equipment, higher reliability and accuracy of assessing the volume of the pathological process in children with primary forms of tuberculosis by determining leading X-ray syndrome and degree of prevalence of pathological changes on the side of intramammary lymph nodes and/or lungs by means of X-ray computed tomography of thoracic organs.

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